Complex karyotypes and KRAS and POT1 mutations impact outcome in CLL after chlorambucil-based chemotherapy or chemoimmunotherapy.

Genetic instability is a feature of chronic lymphocytic leukemia (CLL) with adverse prognosis. We hypothesized that chromosomal translocations or complex karyotypes and distinct somatic mutations may impact outcome after first-line chemoimmunotherapy of CLL patients. We performed metaphase karyotyping and next-generation sequencing (NGS) of 85 genes in pretreatment blood samples obtained from 161 patients registered for CLL11, a 3-arm phase 3 trial comparing frontline chlorambucil (Clb) vs Clb plus rituximab (Clb-R) or Clb plus obinutuzumab in CLL patients with significant comorbidity. Chromosomal aberrations as assessed by karyotyping were observed in 68.8% of 154 patients, 31.2% carried translocations, and 19.5% showed complex karyotypes. NGS revealed 198 missense/nonsense mutations and 76 small indels in 76.4% of patients. The most frequently mutated genes were NOTCH1, SF3B1, ATM, TP53, BIRC3, POT1, XPO1, and KRAS Sole chemotherapy, treatment with Clb-R, or genetic lesions in TP53 (9.9% of patients) and KRAS (6.2% of patients) were significantly associated with nonresponse to study therapy. In multivariate models, complex karyotypes and POT1 mutations (8.1% of patients) represented significant prognostic factors for an unfavorable survival, independently of IGHV mutation status, Binet stage, and serum ß-2-microglobuline. Patients with the copresence of complex karyotypes and deletions/mutations involving TP53 demonstrated a particularly short survival. In summary, this is the first prospective, controlled study in CLL patients that shows a role of complex karyotype aberrations as an independent prognostic factor for survival after front-line therapy. Moreover, the study identifies mutations in KRAS and POT1 as novel determinants of outcome after chemoimmunotherapy using chlorambucil and anti-CD20 treatment.

Inferred kinship patterns reveal low levels of extra-pair paternity in the endangered Neotropical Jabiru Stork (Jabiru mycteria, Aves: Ciconiiformes).

The present study inferred the genetic mating system in a natural breeding population of the Jabiru Stork (Jabiru mycteria), a Neotropical wading bird considered endangered in part of its distribution range. Based on data from eight microsatellite loci, maximum-likelihood kinship reconstruction techniques, parentage assignment analyses and effective population size (Ne) estimates were applied to samples collected in the Brazilian Pantanal wetland (N = 45 nestlings from 20 nests; N = 17 shed adult feathers from 11 nests). The relationship diagnosis was determined for most of the complete clutches (86.66 %): 92.31 % were full siblings and 7.69 % were half siblings. Shed feathers collected from the nests matched the genetic parents of the offspring in 80 % of cases. Feathers collected from the ground below the nests were compatible with the putative parents in 41.67 % of cases. A mean Ne of 35 reproductive individuals was inferred, corresponding to an Ne/Nc ratio of 0.09, which is similar to the ratio found in populations of a number of different wild animals. The higher proportion of full siblings identified in the broods suggests that genetic monogamy is the prevalent mating system in the Jabiru Stork, while the detection of half siblings suggests some degree of extra-pair paternity. The present findings are in agreement with previous ecological observations of social monogamy in this species, despite the isolated evidence of extra-pair copulation events. This study also demonstrates the usefulness of a noninvasive approach to sampling adults and performing parentage and relatedness analyses in an elusive, threatened species.

Patient-specific analysis of FLT3 internal tandem duplications for the prognostication and monitoring of acute myeloid leukemia.

OBJECTIVES: Internal tandem duplications (ITDs) of the fms-like tyrosine kinase 3 ( FLT3) gene occur in 13-35% of patients with acute myeloid leukemia (AML). FLT3-ITD is associated with poor clinical outcome and is an indication for allogeneic stem cell transplantation (allo-SCT). METHODS: To investigate FLT3-ITD length, position, and mutational load in AML cases, we developed patient-specific quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) assays and correlated the results with established sensitive minimal residual disease (MRD) parameters and clinical outcome. RESULTS: In 409 patients with AML, FLT3-ITDs could be detected in 54 cases (13%). Within our cohort, patients with FLT3-ITD ≥ 45 base pairs had significantly higher relapse rates (P = 0.03) and a worse overall survival (P = 0.03). Our method could be applied to 97% of FLT3-ITD-positive patients and was as sensitive as other MRD parameters such as PML-RARA , NPM1 mutations, or MLL -PTD (correlation: r = 0.63; 0.99, and 0.99, respectively). MRD negativity predicted lasting remission independent of allo-SCT (N = 7) or non-allo-SCT (N = 9). All paired diagnostic/relapsed samples showed FLT3-ITD positivity. Compared with bone marrow samples, FLT3-ITD analyses appeared to be equivalently sensitive in peripheral blood. CONCLUSIONS: We conclude that individualized monitoring of FLT3-ITD in patients with AML may guide treatment decisions and should be evaluated for the indication for allo-SCT.

Sedentary nestlings of Wood Stork as monitors of mercury contamination in the gold mining region of the Brazilian Pantanal.

Sedentary organisms that are at top trophic levels allow inference about the level of local mercury contamination. We evaluated mercury contamination in feather tissue of nestling Wood Storks (Mycteria americana), sampled in different parts of the Brazilian Pantanal that were variably polluted by mercury releases from gold mining activities. Levels of mercury in feathers sampled in seven breeding colonies were determined by atomic absorption spectroscopy, and the mean value of mercury concentration was 0.557 µg/g, dry weight (n=124), range 0.024-4.423 µg/g. From this total sample, 21 feathers that represent 30% of nestlings collected in Porto da Fazenda and Tucum colonies, in the northern region, ranged from 1.0 to 4.43 µg/g, dry weight (median value=1.87 µg/g). We found significant differences among regions (H=57.342; p=0<0.05). Results suggest that permanently flooded areas, or along mainstream rivers are more contaminated by mercury than dry areas, regardless of the distance from the gold mining center, which is located in the northern Pantanal. Highest values found in nestlings feathers were similar to those found in feathers of adult birds and in tissues of adult mammals that are less sedentary and were captured in the same region of Pantanal. These findings indicate that mercury released has been biomagnified and it is present in high concentrations in tissues of top consumers. We suggest a program to monitor mercury availability in this ecosystem using sedentary life forms of top predators like Wood Storks or other piscivorous birds.

Avian haemosporidians in the cattle egret (Bubulcus ibis) from central-western and southern Africa: High diversity and prevalence.

We described the geographic distribution of 82 haemosporidian lineages (Plasmodium, Haemoproteus, and Leucocytozoon) in the cattle egret sampled in five countries in central-western and southern Africa. Seventy-three lineages have not previously been reported. We determined the prevalence of three haemosporidians in the samples. We investigated the influence of the internal environment of the host and environmental variables on the Plasmodium diversity and whether environmental variables may explain spatial variations in the prevalence of Plasmodium. We screened DNA from 509 blood samples from nestlings in 15 African colonies for infection by sequencing the cytochrome b gene of parasites. The molecular phylogenetic analysis was performed using Bayesian methods and including sequences from the MalAvi and GeneBank databases. We found 62 new Plasmodium lineages in a clade with MYCAME02, which is a lineage described in waterbirds and recently identified in birds of prey as Plasmodium paranucleophilum. Two Haemoproteus lineages identified in cattle egret formed a distinct group with Haemoproteus catharti and MYCAMH1 (Haemoproteus spp.). Seven Leucocytozoon lineages found in the cattle egret clustered with Leucocytozoon californicus. We found different Plasmodium diversities among the colonies sampled, demonstrating that the internal environment of the host is not the primary determinant of diversity. A linear mixed-effects multivariate model showed that precipitation was positively associated with Plasmodium diversity when controlling for the effects of temperature, colony composition (mixed and non-mixed species) and country. Moreover, a generalized mixed model showed that temperature was positively associated with the prevalence of Plasmodium when controlling for precipitation, elevation and country. We conclude that the cattle egret is a good model for future haemosporidian studies, as we found a significant number of new lineages in this host, which occupies regions with different climate characteristics where environmental variables exert an influence on the diversity and prevalence of Plasmodium.

Lean methodology implementation in the emergency department of a university hospital: management and sustainable development / Implantación de la metodología lean en el servicio de urgencias de un hospital universitario: gestión y desarrollo sostenible / Implementação da metodologia lean na emergência de um hospital universitário: gestão e desenvolvimento sustentável

ABSTRACT Objective: to describe the implementation of the Lean Methodology in an emergency department and its contribution to sustainable and quality management. Method: this is a methodological study carried out between October 2018 and January 2022 in the adult emergency department of a public university hospital in southern Brazil, analyzing the results before and after the implementation of the Lean Methodology. The study followed the model and standards adopted by the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) for the description of improvement cycle standards. Results: with the implementation of this methodology, actions were developed, such as innovations in work routines, both care and management, changes in patient reception with risk classification, construction of units for patient care and allocation, daily interdisciplinary meetings (huddle), full contingency plan, hospital discharge routines, external transfers, changes in the communication process with users and professionals, among other actions. Conclusion: the use of the Lean Methodology has resulted in a reduction in occupancy, which has helped to optimize health resources and ensure quality care and management practices. This reduction is believed to be proof of sustainable management in health services and contributes to reducing socio-economic inequalities.

RESUMEN Objetivo: describir la aplicación de la Metodología Lean en un servicio de urgencias y su contribución a una gestión sostenible y de calidad. Método: se trata de un estudio metodológico realizado entre octubre de 2018 y enero de 2022 en el servicio de urgencias de adultos de un hospital universitario público del sur de Brasil, analizando los resultados antes y después de la implementación de la Metodología Lean. El estudio siguió el modelo y las normas adoptadas por el Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) para describir las normas de los ciclos de mejora. Resultados: con la implementación de esta metodología, se desarrollaron acciones como innovaciones en las rutinas de trabajo, tanto asistenciales como de gestión, cambios en la recepción con clasificación de riesgo, construcción de unidades de atención y asignación de pacientes, reuniones interdisciplinarias diarias (huddle), plan de contingencia completo, rutinas de alta hospitalaria, traslados externos, cambios en el proceso de comunicación con usuarios y profesionales, entre otras acciones. Conclusión: la utilización de la Metodología Lean ha dado lugar a una reducción de los efectivos, lo que ha permitido optimizar los recursos de atención sanitaria y garantizar prácticas asistenciales y de gestión de calidad. Se considera que esta reducción es una prueba de gestión sostenible en los servicios de salud y contribuye a reducir las desigualdades socioeconómicas.

RESUMO Objetivo: Descrever a implementação da Metodologia Lean em um serviço de emergência, e a contribuição para uma gestão sustentável e de qualidade. Método: Trata-se de estudo metodológico, realizado entre outubro de 2018 a janeiro de 2022, no serviço de emergência adulto de um hospital público universitário no Sul do Brasil, com análise de resultados antes e após a implementação da Metodologia Lean. O estudo seguiu o modelo e as normas adotadas pelo Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) para a descrição dos padrões dos ciclos de melhoria. Resultados: Com a implementação desta metodologia, foram desenvolvidas ações, como inovações nas rotinas de trabalho, tanto assistenciais como gerenciais, mudanças no acolhimento com classificação de risco, construção de unidades para atendimento e alocação de pacientes, reuniões diárias interdisciplinares (huddle), plano de contingência pleno, rotinas de altas hospitalares, transferências externas, mudança no processo de comunicação com usuários e profissionais, dentre outras ações. Conclusão: A utilização da Metodologia Lean resultou na diminuição da lotação e com isto pode-se otimizar recursos de saúde e assegurar práticas assistenciais e gerenciais de qualidade. Acredita-se que esta diminuição seja a comprovação de uma gestão sustentável em serviços de saúde e colabora para a redução de desigualdades socioeconômicas.

Complications following the ross procedure: cardiac MRI findings.

Aortic valve replacement with a pulmonary autograft (ie, Ross procedure) is a technique used in selected cases for the treatment of aortic valve disease. Aware of reports describing chronic complications after the Ross procedure such as aortic insufficiency, right ventricular outlet obstruction, aortic autograft dilatation, and pulmonary allograft stenosis, cardiac magnetic resonance imaging (MRI) was performed in individuals who had a previous Ross procedure (range 2 to 10 years earlier) to determine if these complications could be visualized by MRI. This case study presents the MRI findings of 5 patients (mean age: 42.0+/-7.8 years). In each patient, complications of the Ross procedure were observed. These results suggest that cardiac MRI has the potential to become a clinically important technique for evaluating post-Ross procedure patients.

Effect of three months of periodized hydrogymnastics exercise program on urinary concentration of deoxypyridinoline in older women.

OBJECTIVE: To determine the effect of three months of periodized hydrogymnastics exercise program on urinary concentration of deoxypyridinoline in older women. SUBJECTS AND METHODS: Twenty-six subjects were randomly assigned in two, intervention group (n = 16) and control group (n = 10). The intervention group followed 12-week of periodized hydrogymnastics training program five times a week, 50 minutes of water exercise with work heart rate reserve of 40-50% (1-6th week) increasing the load to 50-60% (7-12th week); the control group was not involved in exercise and remained sedentary. The urinary concentration of deoxypyridinoline was evaluated by high resolution liquid chromatography using the reactive immulite pyrilinks-D siemens medical solutions, pretest at the baseline and at the end post-test of the 12-week of water-exercise. As statistical analyses mixed 2 x 2 ANOVA was used, also percentage changes (Δ %) was calculated. RESULTS: The results did not show significant improvement (p < 0.05) comparing the interaction intergroup and the measurements of urinary concentration of deoxypyridinoline (p = 0.504), percentage change (Δ %) showed positive improvements in the experimental group of -13.7 (nM/mMcreatine) in comparison with -7.1 (nM/mMcreatine) from the control group. CONCLUSION: The present study involves periodization increasing the load heart rate reserve of hydrogymnastics exercise in order to produce grater adaptations, but the results showed than is not possible to infer that hydrogymnastics is effective in increase urinary concentration of deoxypyridinoline in older women, will be appropriated in the future more studies to better clarify the possibilities of improvements between hydrogymnastics and urinary concentration of deoxypyridinoline.

Effects of a 20-week concurrent training program on bone metabolism in elderly women / Efecto de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores

The present study evaluated the effect of a 20-week concurrent training program on bone metabolism in elderly women. The sample consisted of 51 elderly women living in the municipality of Muriaé (MG), distributed into two groups: a concurrent training group (CTG = 25), with an average age of 69.44 ± 6.82 years, and a control group (CG = 26), with mean age of 68.30 ± 6.34 years. Biophysical parameters were determined based on weight, height and body mass index. Bone metabolism was assessed by collecting second-morning urine samples before and after intervention to analyze levels of the biochemical marker deoxypyridinoline (DPD), which quantifies bone resorption. Results: The results showed a post-intervention decline in DPD content in the GTC when compared to controls (p = 0.007) and an improvement in the variables weight, BMI and DPD between the GTC and GC (p = 0.000). Conclusion: Concurrent training was efficient in improving bone metabolism in the elderly population studied.

El presente estudio evaluó los efectos de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores. La muestra fue compuesta por 51 mujeres adultas mayores, residentes en el municipio de Muriaé (MG), voluntarias, distribuidas en dos grupos, un grupo participó en entrenamiento concurrente (GTC=25), con una edad media de 69,44±6,82 años y un grupo control (GC=26) con una media de 68,30±6,34 años. Los parámetros biofísicos se determinaron por medio del peso corporal, la estatura e índice de masa corporal. Para la evaluación del metabolismo óseo, se realizó la recolección de la orina matinal en el pre y post-test, utilizando como reactivo el marcador bioquímico de deoxipiridinolina (DPD) que cuantifica la reabsorción ósea. Los resultados mostraron una reducción en la concentración de DPD en el GTC cuando se compararon los grupos (p = 0,007) y la mejora de las variables, peso corporal, IMC y DPD entre el GTC y el GC en el post-test (p = 0,000). Se percibe que el entrenamiento concurrente, para las mujeres adultas mayores fue eficiente en la mejoría de las condiciones de salud del metabolismo óseo.

Efeitos de 20 semanas de treinamento combinado na capacidade funcional de idosas / Effects of 20 weeks of combined training on the functional capacity of elderly / Efectos de 20 semanas de entrenamiento combinado en la capacidad funcional de mujeres ancianas

Resumo O estudo baseou-se em avaliar os efeitos de 20 semanas de treinamento combinado na capacidade funcional de idosas; 66 foram divididas por randomização em dois grupos, um grupo treinamento combinado (GTC, n = 33, com 69,12 ± 7 anos) e outro grupo controle (GC, n = 33, com 69,21 ± 6,60 anos). O período de intervenção da pesquisa ocorreu durante 20 semanas. A avaliação da CF foi feita pela Escala de Atividade da Vida Diária (AVD) proposta por Katz, associada à Escala das Atividades Instrumentais da Vida Diária (AIVD) proposta por Lawton. Para o treinamento de força muscular, usou-se carga máxima entre 70-85% de 1RM e no treinamento de resistência cardiovascular optou-se pelo uso de 70-89% da FC de reserva. Os resultados apresentam melhorais estatisticamente significativas na escala de CF de Lawton (Δ% = 21,04%, p = 0,007) e na escala de CF de Katz, (Δ% = 7,31%, p < 0,001) comparados com os do GC. Os resultados possibilitam concluir que a prática do treinamento combinado melhorou a CF de idosas.

Abstract The study was based on evaluating the effects of 20 weeks of concurrent training on the functional capacity of elderly. 66 elderly women were divided by randomization into two groups, a concurrent training group (CTG, n = 33, with 69,12 ± 7,00 years) and a control group (CG, n = 33, with 69,21 ± 6,60 years). The study intervention period occurred during 20 weeks. The evaluation of the CF was made by the Daily Life Activity Scale (ADL) proposed by Katz, associated with the Scale of Instrumental Activities of Daily Living (IADL) proposed by Lawton. For muscle strength training, maximum load was used between 70-85% of 1RM and in cardiovascular resistance training, 70-89% of reserve HR was used. The results show statistically significant improvement in CF Lawton scale (Δ% = 21,04%, p = 0,007) and CF scale Katz (Δ% = 7.31%, p < 0,001) compared to the control group. The results allow to conclude that the practice of concurrent training improved CF elderly.

Resumen El estudio se basó en la evaluación de los efectos de 20 semanas de entrenamiento combinado en la capacidad funcional (CF) de mujeres ancianas. Se dividió a 66 mujeres ancianas en dos grupos de forma aleatoria: un grupo de entrenamiento combinado (GEC, n = 33, con 69,12 ± 7,00 años) y un grupo control (GC, n = 33, con 69,21 ± 6,60 años). El período de la intervención fue 20 semanas. La evaluación de la CF se llevó a cabo con la Escala de Actividades de la Vida Diaria (AVD), propuesta por Katz, relacionada con la Escala de Actividades Instrumentales de la Vida Diaria (AIVD), propuesta por Lawton. Para el entrenamiento de la fuerza muscular se utilizó una carga máxima del 70-85% de 1RM y para el entrenamiento cardiovascular se optó por el uso del 70-89% de la reserva de la FC. Los resultados muestran una mejora estadísticamente considerable en la escala de la CF de Lawton (Δ% = 21,04%, p = 0,007) y la escala de la CF de Katz (Δ% = 7,31%, p < 0,001) en comparación con el grupo control. Los resultados permiten concluir que la práctica de entrenamiento combinado mejoró la CF de las mujeres ancianas.

A rare case of t(11;22) in a mantle cell lymphoma like B-cell neoplasia resulting in a fusion of IGL and CCND1: case report.

The chromosomal translocation (11;14)(q13;q32) rearranging the locus for cyclin D1 (CCND1) to that of the immunoglobulin heavy chain (IGH) can be found in virtually all cases of mantle cell lymphoma (MCL), while other CCND1 translocations are extremely rare. As CCND1 overexpression and activation is a hallmark of MCL it is regarded as a central biological mechanism in the development and maintenance of this disease.Here we present a patient initially diagnosed with chronic lymphocytic leukemia (CLL) where chromosome banding analysis revealed, among other aberrations, a translocation (11;22)(q13;q11.2). We show by fluorescence in situ hybridization (FISH) analysis that on chromosome 22 the immunoglobulin light chain lambda (IGL) is involved in this cytogenetic aberration. Additionally, we demonstrate the resulting overexpression of CCND1 on the RNA and protein level, thereby consolidating the new diagnosis of a MCL-like B-cell neoplasia. Summing up, we described a rare case of t(11;22)(q13;q11.2) in a MCL-like neoplasia and showed that this aberration leads to an overexpression of CCND1 which is regarded as a key biological feature in MCL. This case underlines the importance of cytogenetic analyses especially in atypical cases of B cell lymphomas.

Efeitos de um programa de treinamento concorrente sobre a autonomia funcional em idosas pós-menopáusicas / Effects of a concurrent training program on functional autonomy in postmenopausal elderly

A perda da autonomia funcional no idoso relaciona-se não somente com a limitação no estado físico, mas também a função cognitiva e psíquica, tornando-o mais inativo no meio social em que convive. Dessa forma, é de suma importância à inserção do idoso em programas que estimulem a prática regular de exercício físico e o convívio social. O presente estudo centrou-se em avaliar os efeitos de um programa de treinamento concorrente sobre a autonomia funcional de idosas pós-menopáusicas. Foram selecionadas 51 idosas, residentes no município de Muriaé (MG), voluntárias, distribuídas em dois grupos, um grupo treinamento concorrente (GTC=25), com média de idade de 69,44±6,82 anos e um grupo controle (GC=26) com média de idade de 68,30±6,34 anos. Os parâmetros biofísicos foram estimados por meio da massa corporal, estatura e índice de massa corporal. A avaliação da autonomia funcional foi feita pela bateria de testes do Grupo de Desenvolvimento Latino-Americano para a Maturidade (GDLAM), composta de: caminhar 10m (C10m), levantar-se da posição sentada (LPS), levantar-se da posição decúbito ventral (LPDV), levantar-se da cadeira e locomover-se pela casa (LCLC) e o teste de vestir e tirar uma camiseta (VTC). Após a intervenção, o GTC apresentou um valor fraco nos testes C10m e LPDV; regular nos testes LCLC, VTC e no índice de GDLAM e bom no teste LPS. Os resultados mostraram que o GTF no pós-teste apresentou melhores resultados em todas as variáveis da autonomia funcional, exceto no teste de LPDV (p=0,057) em relação ao GC (p<0,0125). Na avaliação intragrupos no GTC, encontrouse diferenças estatisticamente significativas para os testes de autonomia funcional C10m (p=0,007), LPS (p=0,000) e IG (p=0,007). Esta pesquisa confirma que a prática regular de exercício físico é essencial para a restauração e controle da autonomia funcional na população de idosos.(AU)

The loss of functional independence in the elderly is related not only to the limitation in physical state, but also the cognitive and mental function, making it inactive in the social environment in which lives. Thus, it is of paramount importance to the insertion of the elderly in programs that encourage the regular practice of physical exercise and social interaction. This study focused on evaluating the effects of a concurrent training program on functional autonomy of postmenopausal elderly. 51 elderly were selected residents in the city of Muriaé (MG), volunteers, divided into two groups, a concurrent training group (CTG=25), with a mean age of 69.44±6.82years and a control group (CG=26) with mean age of 68.30±6.34 years. The biophysical parameters were estimated using the body mass, height and body mass index. The assessment of function0061l autonomy was made by the test battery of the Latin American Development Group for Maturity (LADGM), composed of: walk 10m (W10m), rising from a sitting position (RSP), rising from a recumbent position ventral (RRPV), rising from a chair and walk around the house (RCWH) and the test of wear and take a T-shirt (WTT). After the intervention, the CTG offered very little value in W10m and RRPV tests; regular in RCWH testing, WTT and index LADGM and good in RSP test. The results showed that the CTG in the post-test showed better results in all the variables of the functional autonomy, except in the test RRPV (p=0.057) compared to the CG (p <0.0125). In intragroup evaluation in CTG, we found statistically significant differences in the functional autonomy tests W10m (p=0.007), RSP (p=0.000) and index LADGM (p=0.007). This research confirms that regular physical activity is essential for the restoration and control of the functional autonomy of the elderly population.(AU)

Effect of three months of periodized hydrogymnastics exercise program on urinary concentration of deoxypyridinoline in older women

ABSTRACT Objective To determine the effect of three months of periodized hydrogymnastics exercise program on urinary concentration of deoxypyridinoline in older women. Subjects and methods Twenty-six subjects were randomly assigned in two, intervention group (n = 16) and control group (n = 10). The intervention group followed 12-week of periodized hydrogymnastics training program five times a week, 50 minutes of water exercise with work heart rate reserve of 40-50% (1-6thweek) increasing the load to 50-60% (7-12th week); the control group was not involved in exercise and remained sedentary. The urinary concentration of deoxypyridinoline was evaluated by high resolution liquid chromatography using the reactive immulite pyrilinks-D siemens medical solutions, pretest at the baseline and at the end post-test of the 12-week of water-exercise. As statistical analyses mixed 2 x 2 ANOVA was used, also percentage changes (Δ %) was calculated. Results The results did not show significant improvement (p < 0.05) comparing the interaction intergroup and the measurements of urinary concentration of deoxypyridinoline (p = 0.504), percentage change (Δ %) showed positive improvements in the experimental group of -13.7 (nM/mMcreatine) in comparison with -7.1 (nM/mMcreatine) from the control group. Conclusion The present study involves periodization increasing the load heart rate reserve of hydrogymnastics exercise in order to produce grater adaptations, but the results showed than is not possible to infer that hydrogymnastics is effective in increase urinary concentration of deoxypyridinoline in older women, will be appropriated in the future more studies to better clarify the possibilities of improvements between hydrogymnastics and urinary concentration of deoxypyridinoline. Arch Endocrinol Metab. 2015;59(6):523-7.